Liu Z H, Liu J W, Chan Fion Sy, Li Michael Kw, Fan Joe Km
Department of Surgery, The University Hong Kong-Shenzhen Hospital, Shenzhen, China.
Department of Surgery, The University of Hong Kong, HKSAR, China.
Asian J Endosc Surg. 2020 Jan;13(1):19-24. doi: 10.1111/ases.12704. Epub 2019 Apr 17.
Laparoscopic colorectal resection is becoming the gold standard for treating colorectal cancers because it offers superior short-term and comparable long-time outcomes compared to open surgery. Intraoperative colonoscopy (IOC) is increasingly performed for tumor localization and mucosal assessment. The aim of this report was to review the safety and efficacy of IOC in laparoscopic colorectal surgery.
A MEDLINE search of studies of IOC in laparoscopic colorectal surgery was performed. We focused on three aspects of IOC use: (i) IOC for intraoperative tumor localization; (ii) colonic irrigation and IOC for obstructive left-sided colorectal cancers; and (iii) IOC for assessing colorectal anastomosis.
During laparoscopic colorectal surgery, IOC enables accurate localization of early mucosal tumors, detection of lesions in the proximal unexamined colon for obstructive left-sided cancer, and visual assessment of anastomosis. Additionally, IOC allows for proper surgical resection, management of concomitant lesions, immediate maintenance of hemostasis, suture repair of leaks, and the creation of a protective stoma as necessary.
Intraoperative colonoscopy is beneficial in laparoscopic colorectal surgery. Experienced surgical endoscopists should be trained to safely perform IOC.
腹腔镜结直肠癌切除术正成为治疗结直肠癌的金标准，因为与开放手术相比，它具有更好的短期疗效和相当的长期疗效。术中结肠镜检查（IOC）越来越多地用于肿瘤定位和黏膜评估。本报告的目的是回顾IOC在腹腔镜结直肠癌手术中的安全性和有效性。
对腹腔镜结直肠癌手术中IOC的研究进行了MEDLINE检索。我们关注IOC使用的三个方面：（i）用于术中肿瘤定位的IOC；（ii）用于梗阻性左侧结直肠癌的结肠灌洗和IOC；以及（iii）用于评估结直肠吻合口的IOC。
在腹腔镜结直肠癌手术中，IOC能够准确定位早期黏膜肿瘤，检测梗阻性左侧结肠癌近端未检查结肠中的病变，并对吻合口进行视觉评估。此外，IOC允许进行适当的手术切除、处理伴随病变、即时止血、缝合修复渗漏，并在必要时创建保护性造口。
术中结肠镜检查在腹腔镜结直肠癌手术中是有益的。应培训有经验的外科内镜医师安全地进行IOC。
